reality that the psychotic patient appears unable to grasp has been effected. In dealing with psychosis, Jacques Lacan also urges psychiatrists and psychoanalysts to question their own trust in the order of reality (1977:216), to halt diagnosis, and to let patients define their own terms.
“There is intuitive intelligence, which is not transferable by speech,” said a patient in a conversation with Lacan. “I have a great deal of difficulty in logifying. . . . I don’t know if that is a French word, it is a word I invented” (1980:27). We are here faced with the patient’s making of meaning in a clinical world that would rather assign such meaning (see Corin 1998; Corin, Thara, and Padmavati 2003). We are also faced with Lacan’s important insight (drawn not only from intellectualization but also from his psychoanalytic practice)10 that the unconscious is grounded in rationality and in the interpersonal dimension of speech: “It is something that comes to us from the structural necessities, something humble, born at the level of the lowest encounters and of all the talking crowd that precedes us . . . of the languages spoken in a stuttering, stumbling way, but which cannot elude constraint” (1978:47, 48). For Lacan, subjectivity is that failed and renewable and all too human attempt to access the truth of oneself.11 As I listened to Catarina, I saw a picture of social life emerging as agonizing and uncertain, as order and chaos, as it was actually lived.
Through and beyond subjective recollection and archival representations, my ethnographic work approached the stubborn (though ambiguous), concrete, and irreducible experience of Catarina’s being in relation to others, to what was at stake for them in her vanishing from reality, and to what counted for her now (Kleinman 1999; Das 2000). In her own words:
I know because I passed through it
I learned the truth
And I try to divulge what reality is
It was not a matter of finding a psychological origin (a thing I don’t think exists) for Catarina’s condition or solely of tracking down the discursive templates of her experience. I understand the sense of psychological interiority as being ethnological, as the whole of the individual’s behavior in relation to his or her environment and to the measures that define boundaries, be they legal, medical, relational, or affective. It is in family complexes and in technical and political domains, as they determine life possibilities and the conditions of representation, that human behavior and its paradoxes belong to a certain order of being in the world.12
How does one become another person today? What is the price one pays? How does this change in personal life become part of memory, individual and collective? By way of her speech, the unconscious, and the many knowledges and powers whose histories she embodies, there is the plastic power of Catarina as she engages all this and tries to make her life, past and present, real, both in thought and in writing.
In working with Catarina, I found Byron Good’s study of epidemic-like experiences of psychoses in contemporary Indonesia particularly illuminating (2001). While directing attention to how the experiences of acute brief psychoses are entangled with the country’s current political and economic turmoil, the ghostliness of its postcolonial history, and an expanding global psychiatry, Good emphasizes the ambiguities, dissonances, and limitations that accompany all attempts to represent subjectivity in mental illness. He suggests three analytic moves: the first, working inward through cultural phenomenology to discover how the person’s experience and meaning-making are woven into the domestic space and its forceful coherence; the second, bringing to the surface the affective impact and political significance of representations of mental illness and subjectivity; and the third, interpreting outward to the immediate economic, social, and medical processes of power involved in creating subjectivity.13 Good unremittingly resists closure in his analysis, challenging us to bring movement and unfinishedness into view.
As Catarina and I disentangled the facts of her existence, both the ordinariness of her abandonment and the ways it was forged in the unaccounted-for interactions of family, psychiatry, and other public services came into view. In the process, I also learned that the overpowering phenomenology of what is generally taken and treated as psychosis lies not in the psychotic’s speech (Lacan 1977) but in the actual struggles of the person to find her place in a changing reality vis-à-vis people who no longer care to make her words and actions meaningful. Catarina’s human ruin is in fact symbiotic with several social processes: her migrant family’s industrious adherence to new demands of progress and eventual fragmentation, the automatism of medical practices, the increasing pharmaceuticalization of affective break-downs, and the difficult political truth of Vita as a death script. Adopting a working concept, I began to think of Catarina’s condition as social psychosis. By social psychosis, I mean those materials, mechanisms, and relations through which the so-called normal and minimally efficient order of social formations—the idea of reality against which the patient appears psychotic—is effected and of which Catarina is a leftover.
Catarina was constantly recalling the events that led to her abandonment. But she was not simply trying to make sense of them and to find a place for herself in history, I thought. By going through all the components and singularities of these events, she was resuming her place in them “as in a becoming,” in the words of Gilles Deleuze, “to grow both young and old in [them] at once. Becoming isn’t part of history; history amounts only to the set of preconditions, however recent, that one leaves behind in order to ‘become,’ that is, to create something new” (1995:170–171). As Catarina rethought the literalism that made possible a sense of exclusion, she demanded one more chance in life.
This is a dialogic ethnography, and the book’s progression mirrors the progression of our joint work. Both Catarina’s efforts, as desperate as they were creative, to write herself back into people’s lives and the anthropologist’s attempts to support her search for consistency and demands for a possibility other than Vita are documented here. The narrative is constructed around my conversations with Catarina and the many people with whom we interacted as the study and related events unfolded—the other abandoned persons and the caretakers in Vita, Catarina’s extended family, public health and medical professionals, and human rights activists. I personally conducted all the interviews that compose the main body of the text and translated them to the best of my ability; they appear chronologically and have been edited only for the sake of clarity and conciseness.14 I wanted the book’s texture to stay as close as possible to Catarina’s words, to her own thinking-through of her condition, and to the reality of Vita, which envelops Catarina and her words.
Fieldwork and archival research further addressed the circuits and actions—the verbs, if you will—in which those words and thoughts were entangled, illuminating their worldliness and that of the social practices that affected Catarina. The book follows a logic of discovery. Throughout the narrative, I provide glosses on the history and scale of the various forces impinging on her abandonment. Just as I would like Catarina to talk to the reader, I also would like the reader to become increasingly intimate with the broader social terrain in which her destiny was configured as nonsensical and valueless. The book is written in a recursive mode, to convey the messiness of both the world and the real struggles in which Catarina and her kin were involved. At each juncture, a new valence of meaning is added, a new incident illuminates each of the lives in play. Long-term ethnographic engagement crystallizes complexity and systematicity: details, often dramatically narrated, reveal the nuanced fabric of singularities and the logic that keeps things the same. This ethnographic sense of ambiguity, repetition, and openness collides with my own sensibility in the way I have tried to portray the book’s main characters: as living people on the page, with their own mediated subjectivities, whose actions are both predetermined and contingent, caught in a constricted and intolerable universe of choices that remains the only source from which they can craft alternatives.
Tracking the many interconnections of
